Web-Based Patient-Reported Outcome Measures for Personalized Treatment and Care (PROMPT-Care): Multicenter Pragmatic...

Area of Science:

• Oncology
• Digital Health
• Health Services Research

Background:

• Electronic patient-reported outcome (ePRO) systems show promise but face implementation challenges in routine clinical care.
• Despite proven efficacy, integrating ePRO into daily practice remains a significant hurdle.

Purpose of the Study:

• To evaluate the effectiveness of the PROMPT-Care web-based system in routine clinical workflows for diverse cancer patients.
• To assess the impact of ePRO implementation on emergency department presentations, chemotherapy duration, and allied health referrals.

Main Methods:

• A pragmatic trial involving adult patients with solid tumors across four cancer centers.
• The PROMPT-Care intervention included monthly ePRO assessments, automated clinical alerts, and tailored self-management resources.
• Propensity score matching (1:4 ratio) was used to compare intervention patients with controls based on age, sex, and treatment status.

Main Results:

• Emergency department visits decreased by 33% (P=.02) in the PROMPT-Care group compared to controls.
• No significant differences were observed in allied health referrals or time to chemotherapy completion.
• Automated alerts triggered by patient-reported symptoms (e.g., fatigue, worry) were frequently reviewed by nursing staff.

Conclusions:

• Algorithm-supported ePRO systems can reduce emergency department visits in cancer care.
• Automated alerts, nurse engagement, and guided self-management resources are crucial for successful ePRO integration.
• These findings provide a framework for incorporating web-based PRO systems into future cancer care models.